Background: This study aimed to assess the relationship between the use of dexmedetomidine and the incidence of acute kidney injury (AKI) in septic shock patients undergoing mechanical ventilation and reveal the potential mechanism.
Methods: Septic shock patients undergoing mechanical ventilation were included. Patients were randomized into two groups including propofol group and dexmedetomidine group. Plasma samples were obtained from veins at 0, 12, 24, 72 and 120 h after receiving mechanical ventilation in ICU.
Results: Cohorts with septic shock after mechanical ventilation in ICU had similar baseline and demographic characteristics. Serum creatinine (SCr) and blood urea nitrogen (BUN) was lower in dexmedetomidine group (P<0.05) and also lower renal injury markers were detected in the dexmedetomidine group, compared with propofol group (P<0.05). Dexmedetomidine infusion reduced the TNF-α, IL-1 level in blood samples and maintained the balance of proportion of CD4+ and CD8+ T-lymphocytes. Patients receiving dexmedetomidine were less likely to develop AKI. The median ICU stay was decreased in dexmedetomidine group (P<0.05). Moreover, the case and duration of CRRT was also decreased by using dexmedetomidine (P<0.05). There was no significant difference between the cohorts with respect to the duration of mechanical ventilation.
Conclusions: The use of dexmedetomidine infusion in ICU patients was associated with a decreased incidence of AKI and reduced ICU stay and CRRT performance. The mechanism may be related to antiinflammatory reaction and immunoregulation.
Keywords: Acute kidney injury (AKI); dexmedetomidine; mechanical ventilation; multiple organ dysfunction syndrome (MODS).